Global Coagulation Testing in Acute Care Medicine: Back to Bedside?

Abstract: Objectives Detailed and decisive information about the patients' coagulation status is important in various emergency situations. Conventional global coagulation testing strategies are often used to provide a quick overview, but several limitations particularly in the trauma setting are well described. With the introduction of direct oral anticoagulations (DOACs), a milestone for several disease entities resulting in overall improved outcomes could be reached, but at the same time providing new diagnostic challenges for the emergency situation. Design As an alternative to conventional coagulation tests, there is increasing clinical and scientific interest in the use of early whole blood strategies to provide goal-directed coagulation therapies (GDCT) and hemostatic control in critically ill patients. Viscoelastic hemostatic assays (VHAs) were therefore introduced to several clinical applications and may provide as a bedside point-of-care method for faster information on the underlying hemostatic deficiency. Conclusion The use of VHA-based algorithms to guide hemostatic control in emergency situations now found its way to several international guidelines for patients at risk of bleeding. With this qualitative review, we would like to focus on VHA-based GDCT and review the current evidence for its use, advantages, and challenges in the two different clinical scenarios of trauma and intracerebral bleeding/stroke management.

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch

Bibliographic citation
Global Coagulation Testing in Acute Care Medicine: Back to Bedside? ; volume:42 ; number:06 ; year:2022 ; pages:400-408
Hämostaseologie ; 42, Heft 06 (2022), 400-408

Contributor
Caspers, Michael
Holle, Johannes Fabian
Limper, Ulrich
Fröhlich, Matthias
Bouillon, Bertil

DOI
10.1055/a-1938-1984
URN
urn:nbn:de:101:1-2411071655550.531006439851
Rights
Kein Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
15.08.2025, 7:37 AM CEST

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Associated

  • Caspers, Michael
  • Holle, Johannes Fabian
  • Limper, Ulrich
  • Fröhlich, Matthias
  • Bouillon, Bertil

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